Varicose veins of the lower limbs are a common and frequently-occurring disease in Chinese people. The veins of the lower limbs are composed of superficial veins, deep veins, communicating veins and muscle veins. Usually what we call varicose veins refers to superficial varicose veins (large and small saphenous veins).
Ultrasound-guided positioning of the great saphenous vein in laser surgery
First talk about the diagnosis of varicose veins. In fact, varicose veins should be attributed to a symptom (signs) rather than a separate disease, because the incidence of true primary varicose veins is not too high. Various diseases that cause increased venous pressure can cause varicose veins of the lower extremities. For example, primary deep vein valve insufficiency, deep vein thrombosis, iliac vein compression syndrome (cockett sydrome), arteriovenous fistula, various causes of inferior vena cava compression (retroperitoneal tumors, etc.), Budd-Chiari synthesis Symptoms, severe tricuspid regurgitation, and right heart failure can all cause varicose veins in the lower limbs. Therefore, we need to be cautious about the diagnosis of varicose veins of the lower extremities. If the treatment is only for the superficial varicose veins, it will not take long for it to recur. First of all, the cause must be clear, and then targeted treatment. For example, cockett sydrome first requires stents or surgery to relieve the compression of the iliac veins, and then surgery for varicose veins can be cured.
Before and after cockett sydrome endovascular stent treatment
If the diagnosis is clear, then consider what kind of treatment to take. There are many treatment methods for varicose veins, including surgical treatment and conservative treatment. Surgical treatment includes traditional high-density ligation and stripping, laser endocavity closure surgery, radiofrequency closure technology and cryo-closure technology, Trivex technology and sclerotherapy injection. Conservative treatment, you can wear elastic stockings, oral medication, etc.
It is precisely because there are so many choices that make people confused, which one is the best? In fact, for every patient, there is no one best treatment method, only the most appropriate treatment method. If the symptoms are mild, no pigmentation, no ulcers, you can wear elastic stockings conservative treatment. Especially for female patients, black elastic stockings not only have a therapeutic effect but also have a beautiful leg function, which unintentionally adds a little sexy. But for a man, wearing elastic stockings especially in summer is simply torture. Therefore, it is necessary to consider whether or not to treat varicose veins. In fact, there are many drugs used for varicose veins, but the ones advertised in newspapers have not been verified for efficacy. To put it bluntly, it is invalid. What is clinically effective is that the main ingredient of some western medicines is horse chestnut seed extract, which can relieve related symptoms. For patients who already have hemorrhoids, try it. Because hemorrhoids are also a kind of varicose veins, it's nothing more than different parts. If you want to eat varicose veins with medicine, it is impossible. Therefore, drugs are mainly to relieve symptoms and assist treatment.
The traditional high ligation and stripping of the great saphenous vein during the operation is the oldest and most effective treatment method, but it also has disadvantages: large surgical trauma, impact on the appearance of the incision, and long hospital stay. For women who love beauty, it is too cruel to have many scars on a beautiful leg. Therefore, many alternative treatments have emerged. Now the most popular is laser intracavity closure surgery, in which the laser head is inserted into the varicose vein through interventional methods and the venous cavity is closed by laser cauterization. This kind of surgery can hardly see surgical scars, which is an advantage, but due to the different experience of the surgeon, it may cause recurrence of varicose veins. Poor control of the laser power can lead to skin burns and saphenous nerve damage, and thrombosis may occur after surgery. Phlebitis causes pain, redness and swelling. For patients with severe varicose veins and ulcers, most of them have communicating branches, and laser surgery alone cannot solve the problem. At this time, the use of laparoscopy for subfascial communication branch ligation (SEPS surgery) can solve the problem of ulcers and pigmentation caused by the communication branch through a minimally invasive method. Trivex technology is also a good choice for the superficial veins of the calf flexed into a mass. The disadvantage is that the trivex technology surgical incision is minimally invasive, but the surgical trauma is not small. It is not the first choice for varicose veins....In short, a personalized treatment plan is the most suitable treatment. There is no one way to solve all problems.
The left side of the picture below shows the varicose veins of the lower extremities before the operation, and the right side shows that there is almost no surgical scar after the postoperative review. This is my treatment with minimally invasive surgery
Nowadays, varicose veins of lower limbs are basically DAY SURGERY in European and American countries, which means that patients come to the hospital for surgery in the morning and can be discharged home in the afternoon without hospitalization.But in China, it's not all that can be copied. Because patients in European and American countries are basically diagnosed and targeted treatment when varicose veins are mild due to health awareness and medical insurance level. Few patients are as serious as varicose veins in China. Therefore, laser endocavity closure is sufficient for European and American countries. After the operation, a family doctor can provide consultation and follow-up services, so there is no need to be hospitalized. But domestic patients expect to solve all problems during hospitalization. Because I was discharged from the hospital, I also expected to quickly make money to deal with all kinds of pressure. Therefore, if you ask a patient with varicose veins to be discharged on the same day, it may not work. But we can carry out 2days surgery. You can let the patient stay in the hospital for one or two nights, so that he has a process of acceptance. After all, community follow-up services after patients go home are not as convenient as abroad, and problems involving medical insurance reimbursement are also more troublesome.
However, society is always evolving, and people's requirements are constantly improving. Similarly, the level of medical technology also needs continuous updating and development. It is imperative to standardize the diagnosis process of lower extremity varicose veins and individualized treatment.
Removal of varicose veins under trivex surgery